At Heart and Health Medical Middle Island, our foot and ankle specialist offers the best care in all ailments and diseases related to your ankles and feet. Our Podiatrists diagnose, treat and manage any concerns you have in regards to the bones, muscles, and tendons of the foot and ankle. With a local foot doctor and an experienced team who specialize in injury and illness all of your foot care needs can be met by a top specialist in foot or ankle injury, pain caused by other diseases (ex: Diabetes, Arthritis, etc.), skin and nail disorders (ex: ingrown nails), treatment of infections (ex: bacterial or fungal), and deformities of any cause.
A doctor of podiatric medicine (DPM), or podiatrist, is a physician and surgeon who treats the foot, ankle, and related structures of the leg. Your feet and ankles are intricate anatomical structures, stabilizers, shock absorbers, and momentum generators that are influential to your overall health and well-being and they require expert care.
Heart and Health Medical Middle Island Podiatry
Foot Care Specialists
The foot and ankle work as a team to provide balance, stability, momentum and movement. The anatomy cared for by our Podiatrists includes:
- 26 bones
- 33 joints
- Blood vessels
The ankle incompases three bones attached by muscles, tendons, and ligaments that connect the foot to the leg. The anatomy of the ankle includes:
- Tibia (shin bone)
- Talus (ankle bone)
- Lateral Malleolus: bony protrusion of the outer ankle and is formed by the distal end of the fibula
- Medial Malleolus: bony protrusion of the inner ankle bone formed by the distal end of the tibia
In the lower leg are two bones called the tibia, or shin bone, and the fibula. These bones connect to the Talus, or ankle bone, at the tibiotalar joint, or ankle joint, allowing the foot to move up and down
The foot can be divided into three anatomical sections called the hindfoot, midfoot, and forefoot and the anatomy includes:
- Tarsal bones
- Talus (ankle bone)
- Calcaneus (heel bone)
- Cuneiform Bones
- Metatarsal bones
- Phalanges (toe bones)
- Sesamoid bone
- Plantar fascia ligament
The hindfoot consists of the talus bone and the calcaneus bone. The calcaneus bone is the largest bone in your foot and the talus bone is the highest bone in your foot. The calcaneus joins the talus bone at the subtalar or transverse tarsal joint enabling the foot to rotate at the ankle. The hindfoot connects the midfoot to the ankle at the transverse tarsal joint.
The midfoot contains five tarsal bones: the navicular bone, the cuboid bone, and 3 cuneiform bones. It connects the forefoot to the hind foot with muscles and ligaments. The main ligament is the plantar fascia ligament. The midfoot is responsible for forming the arches of your feet and acts as a shock absorber when walking or running. The midfoot connects to the forefoot at the five metatarsal joints.
The forefoot consists of your toe bones called phalanges and metatarsal bones, the long bones in your feet. Phalanges connect to metatarsals at the ball of the foot by joints called phalange metatarsal joints. Each toe has 3 phalange bones and 2 joints, while the big toe contains two phalange bones and two sesamoid bones that enable the toe to move up and down. Sesamoid bones are bones that develop inside of a tendon over a bony prominence. The first metatarsal bone connected to the big toe is the shortest and thickest of the metatarsals and is the location for the attachment of several tendons.This bone is important for its role in propulsion and bearing weight.
Our feet and ankle bones are held in place and supported by various soft tissues. Soft tissue anatomy includes:
- Cartilage: allows for smooth movement where two bones come in contact with each other.
- Tendons: soft tissue that connects muscles to bones to provide support. The Achilles tendon, also called the heel cord, is the largest and strongest tendon in the body.
- Ligaments: Ligaments are strong rope-like tissue that connects bones to other bones and help hold tendons in place to provide stability of the joints. The plantar fascia is the longest ligament in the foot.
- Muscles: fibrous tissue capable of contracting to cause body movement. There are 20 muscles in the foot and these are classified as intrinsic or extrinsic. The intrinsic muscles are those located in the foot and are responsible for toe movement. The extrinsic muscles are located outside the foot in the lower leg. The gastrocnemius or calf muscle is the largest of these and assists with movement of the foot.
- Bursae: small fluid filled sacs that decrease friction between tendon and bone or skin. Bursae contain special cells called synovial cells that secrete a lubricating fluid.
Common ailments treated by our Podiatrists include, but are not limited to:
Achilles Tendon Rupture
An Achilles tendon rupture occurs when the Achilles tendon, the tendon that runs down the lower back part of the leg to connect two muscles (soleus and gastrocnemius) to the heel bone, is over stretched resulting in the tendon being either partially or completely torn. During contraction, the healthy Achilles tendon moves allowing the foot to point up and down. This contraction is very helpful for movements such as sprinting and jumping.
Treatment for an Achilles tendon rupture can be done surgically and nonsurgically. Nonsurgical methods may include a cast, foot brace, or walking boot. These methods prevent movement of the tendon and will allow the tendon to heal on its own. For more severe cases, surgery may be required. In this case, the surgeon will make an incision on the heel and stitch the tendon back together. Surgery is also accompanied by physical therapy designed to help strengthen and improve the muscle.
**While waiting to seek medical attention, it is important to stay off the foot and to elevate and ice the area to reduce pain and swelling**
An ankle sprain occurs when the ligaments in or around the ankle become injured. In the ankle, the ligaments play a very important role in providing stability for walking and helping prevent excessive side to side motion.
The most common causes of ankle sprains are falling during sports, tripping, and walking on uneven surfaces. When this happens, the joints are moved out of their normal position which causes stress on the surrounding ligaments. Common symptoms of a sprain include pain in the ankle, swelling, bruising, and difficulty walking.
It is important to seek medical treatment for an ankle sprain because if left untreated, it could lead to chronic pain and unsteadiness. Treatment varies depending on the type of sprain. In most cases, non surgical methods are used which include ice, elevation, physical therapy and compression. Only when the ligament is completely torn is surgery necessary.
Athlete’s foot is a fungal infection of the foot. The shoe is the common growth place for this fungus because it is dark and moist. These conditions are perfect for the fungus to flourish. It usually grows on the heel and in between the toes. Most people get athlete’s foot from public showers, swimming pools, and lockers making it a very contagious condition.
Common symptoms of athlete’s foot are cracking skin, burning and itching patches, and oozing blisters. The fungus can also spread to the toenails leaving them discolored and crumbled. Athlete’s foot is very easily treated with medicated cream that contain antifungal agents.
Brachymetatarsia is a medical condition in which one or multiple metatarsals are unusually shorter than the rest. It most commonly occurs in the fourth toe. The main cause of brachymetatarsia is that the growth plate in that bone closes prematurely, resulting in the bone not being fully developed. Once the plate has closed, the bone will not grow anymore.
Even though it may seem minor, brachymetatarsia disrupts the physiology of the foot, mainly interrupting the weight distribution. When a person begins to walk, the weight of the body starts in the fifth toe, and gets passed along until it reached the first toe. If the fourth toe is shorter than the fifth toe, the weight cannot be accurately transferred to the third toe. This means the other toes of the body are given excess weight.
There aren’t many treatment options for people with brachymetatarsia. Shoes with padding and orthotics can help deal with the weight distribution and excess pressure. In some rare cases, surgery may be an option. In this procedure, the shortened toe is cut and a small pieces of bone is inserted between the cut pieces. However, in most cases of brachymetatarsia the toe is too short and surgery is not an option.
A bunion is a bump on the inner side of the foot by the big toe. These occur overtime when the big toe begins to shift inward to the second toe. This shift is what causes the large bump on the side of the foot and usually causes inflammation of the tissue in between the tendon and muscle of the toe.
Treatment of bunions can be surgical or nonsurgical. Nonsurgical options include padding for more support and anti-inflammatory medications to help with the swelling. If the pain is extreme and no other nonsurgical methods work, surgery can be an option. The goal of surgery is to remove the bump and repair the bone structures that have been changed due to the shifting of bones.
Calcaneal apophysitis is a medical condition where the growth plate in the heel becomes inflamed. It most commonly occurs in younger children ages 8-14 because the heel bone is not fully developed. The main cause of this inflammation is overuse and repetitive stress on the heel bone. A child’s heel growth plate is very sensitive to repeated pressure, so children that are involved in running sports are very susceptible to this condition. Other risk factors include obesity and a stiff Achilles tendon.
Corns and Calluses
Corns and calluses are thickened layers of protective skin that results from consistent pressure. When the thickened skin forms on either the top or side of the toe it is referred to as a corn and when the thickened skin is on the bottom of your feet it is called a callus. This thickening of skin is actually a form of protection against blisters.
Corns and calluses are very minor conditions and usually go away overtime. The main way to get rid of these areas of thickened skin is to reduce the amount of friction of the feet. Properly fitted shoes and socks can help prevent corns and calluses.
Charcot Foot (Clubfoot)
Charcot Foot (Clubfoot) is a medical deformity in which the foot points down and inward. This condition is present at birth and affects 1 in every 1,000. It is generally more common in males. There is no exact cause of clubfoot, but it could possibly be genetic.
The most common way to treat a clubfoot is to cast the foot. The sooner the cast is put on the better. Along with the cast, stretching techniques are required. This method is usually successful because a baby’s bones, ligaments, and tendons are all still flexible and easy to manipulate. An average baby will wear five to ten casts during their treatment, wearing each cast for about a week or two. The tenth cast will stay on for about 3 weeks. The baby will then need to wear a fulltime brace for about 3 months and after those 3 months, the brace should be worn only at night and when the baby naps. This last brace should be worn for 3 years. In most cases, the cause of the clubbed foot is a tight Achilles tendon. In half of the cases, the cast will not provide enough correction and surgery is needed to lengthen or shorten the ligaments and tendons.
Other Treatment Services:
Diabetic Limb salvage